MEDICARE: WEISS FOOT AND ANKLE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	MD002582	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790821015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEISS FOOT AND ANKLE CENTER

Provider Business Mailing Address
First Line	:	777 S WHITE HORSE PIKE
Second Line	:	SUITE D1
City	:	HAMMONTON
State	:	NJ
Zip	:	08037-2029
Country	:	US
Telephone Number	:	609-561-2488
Fax Number	:	609-561-2748

Provider Business Practice Location Address
First Line	:	777 S WHITE HORSE PIKE
Second Line	:	SUITE D1
City	:	HAMMONTON
State	:	NJ
Zip	:	08037-2029
Country	:	US
Telephone Number	:	609-561-2488
Fax Number	:	609-561-2748

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. DAVID L WEISS
Credential	:	D.P.M
Telephone Number	:	609-561-2488

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	01/30/2008

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Directions to “WEISS FOOT AND ANKLE CENTER ” Practice Location

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